Healthcare Provider Details

I. General information

NPI: 1811794274
Provider Name (Legal Business Name): KAYLEY HEPLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2025
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38378 MIDLAND TRL E
CALDWELL WV
24925-2100
US

IV. Provider business mailing address

5106 POTTS CREEK RD
COVINGTON VA
24426-7106
US

V. Phone/Fax

Practice location:
  • Phone: 304-520-0182
  • Fax:
Mailing address:
  • Phone: 540-319-0468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number122119
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: